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Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$1,196.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$1,495.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$11.00 with UPMC Health Plan vs $3,883.74 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -99% |
| United Healthcare Community Plan for Families | Unison Kids | $11.50 | ↓ -99% |
| Aetna | Medicaid | $12.00 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.61 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↓ -99% |
| Aetna | Medicare | $373.75 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $539.84 | ↓ -55% |
| Aetna | EBR ASO | $598.00 | ↓ -50% |
| Cigna | Commercial | $598.00 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $747.50 | ↓ -38% |
| Aetna | EBR FI | $867.10 | ↓ -28% |
| Aetna | Neighborhood Network | $897.00 | ↓ -25% |
| Aetna | Home Depot Employer Group | $922.41 | ↓ -23% |
| Aetna | NBR ASO/FI | $941.85 | ↓ -21% |
| Cigna | New Business ASO | $941.85 | ↓ -21% |
| InterGroup | PPO | $971.75 | ↓ -19% |
| Coventry/First Health | Commercial | $1,046.50 | ↓ -13% |
| Health Coalition Partners | PPO | $1,076.40 | ↓ -10% |
| UPMC Health Plan | Commercial | $1,140.24 | ↓ -5% |
| Private Health Care Systems | PPO | $1,196.00 | ↑ +0% |
| Humana | Commercial | $1,270.75 | ↑ +6% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $3,152.20 | ↑ +164% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $3,883.74 | ↑ +225% |
Visitor-reported prices
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Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,196.00 | $11.00 – $1,345.50 |
| UPMC Muncy | Muncy | $1,184.80 | $11.00 – $1,332.90 |
| UPMC Passavant-McCandless | Pittsburgh | $1,195.80 | $11.00 – $1,226.11 |
| UPMC Presbyterian | Pittsburgh | $1,195.80 | $11.00 – $1,226.11 |
| UPMC St. Margaret | Pittsburgh | $1,196.00 | $11.00 – $1,270.75 |
| UPMC Wellsboro | Wellsboro | $1,184.80 | $11.00 – $1,327.50 |
| UPMC Western Psychiatric | Pittsburgh | $1,195.80 | $16.69 – $1,201.47 |
| UPMC Williamsport | Williamsport | $1,184.80 | $11.00 – $1,269.00 |